A better gender balance on boards leads to improved services – so men must watch out for unconscious bias. Photograph: Stockbroker/Alamy

There seems to be a lot of discussion at the moment about women in leadership in the NHS.

This is good – however, it is nearly always being done by women. To some people it would seem odd to have a man speak or write about women in top jobs. How can they understand the issues and challenges that these women face? But this is an issue far greater than one of fairness or equality, and men do need to engage in the debate.

I was recently asked to give a speech on women in leadership and the opportunities and challenges this presents for men. I was surprised that there was only one male delegate, despite the efforts of the organisers. This was especially surprising given that we are trying to ensure a more visibly compassionate NHS – and this will take the leadership of both men and women.

Equality is important, which is why the debate about women leaders is often framed as one of fairness. And it's not just the NHS where this is an issue. In fact, the NHS does better than most. However, Michael West, professor of organisational psychology at Lancaster University, recently wrote that "leadership is the embodiment of culture" – and it is important to recognise that having more women in leadership roles is more than just an issue of equality, and will require organisational change.

A report from the Equality and Human Rights Commission measured the number of women in positions of power and influence, and calculated that at the current rate of change it would take around 70 years to reach an equal number of men and female directors of FTSE 100 companies.

Figures from the report reveal that, while women are graduating from university in increasing numbers and achieve better degree results than men, they only represent 13% of directors of FTSE 100 companies. In the public and voluntary sectors, women only account for 23% of local authority chief executives, 14% of university vice chancellors and 33% of health trust chief executives.

A well-known management theory called the Peter Principle suggests that people who perform well at their job get promoted into different roles until they reach a point where they are no longer good at what they do. But a conflicting theory called the Paula Principle argues that most women work below their level of competence.

It says they are held back by factors such as discrimination and the need to care for relatives. This theory also says that women are often averse to putting themselves forward for promotions; are less likely to have connections higher up the ladder; and sometimes even choose to stay where they are rather than move up to the next level.

It is largely accepted that men and women have different styles of leadership. For women these are often cited as collaboration, conviction, inclusiveness, creation and mentorship – and that is why having women in leadership is far more important than simple equality. We know that more women on boards leads to better services. It can be argued that this is not caused by having more women but rather a better gender balance, but whichever way you look at it the benefits include:

• Better governance; apparently linked to women's ability to better manage and control risk and initiate a different type of boardroom discussion

• Improved collaboration; linked to women's tendency to be more open and inclusive

So the big opportunity for men is that if we have more women in leadership we get better services. Better for patients, better for our families and better for us. Of all the changes NHS culture needs, this one – on paper at least – should be easier to address.

The biggest challenge for men is that we do not fall victim to unconscious bias. We need to stop seeing the "problem" as one of women's leadership style or education. It is us, and the NHS culture, that needs to change.

It is really important that we as a sector continue to ensure increased participation of women in leadership programmes, training and development. And, for that matter, increased participation among the BME community where the gap is even starker. But more importantly we must look our predisposition and prejudice in the face and change our attitudes and understanding.

Without that, we have culture getting in the way of better patient care. This must change.

Dean Royles is chief executive of NHS Employers. You can listen to a podcast of his King's Fund speech here